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Shiao Wei Wong, Pallavi Tyagi, Simon A Hewick; Diabetic Macular Oedema and Intravitreal Bevacizumab (Avastin). Invest. Ophthalmol. Vis. Sci. 2014;55(13):1760.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the clinical effectiveness of intravitreal bevacizumab (Avastin) in the treatment of patients with diabetic macular oedema.
Data was collected retrospectively from August 2012 to February 2013 in Raigmore Hospital, Inverness, Scotland. 19 patients (24 eyes) with clinically significant diabetic macular oedema were included in this study. Response to treatment was monitored by best corrected visual acuity (BCVA) and OCT central retinal thickness (CRT) monthly following treatment. Main outcome measure is any change in BCVA .
A total of 24 eyes of 19 patients received treatment for diabetic macular oedema. Mean age at receiving first injection was 66 years (range 47 - 83 years). The average number of injections in 24 eyes was 3 (range 1-6 injections). Average duration of follow up was 15 months (range 4 - 48 months). 12 eyes out of 24 eyes (50%) showed improvement of vision at final follow up. 2 eyes (8.3%) maintained vision at final follow up. 10 eyes (41.7%) showed worse vision at final follow up. The OCT CRT was reduced in most patients (90.9%) at final follow up but only 45.0% of these patients showed improvement in vision at final follow up.
Our patients with diabetic macular oedema who received Avastin intravitreal injection showed 50% visual response rate to Avastin. OCT CRT was reduced in most patients but there was not a correlation between OCT CRT and visual improvement. Initial OCT CRT is not a useful predictor of visual gain. Ceiling was effect seen in patients with poorer initial vision who are getting more gain in vision than patients with better initial vision. Finally, the subsequent visual response to Avastin can possibly be predicted from visual response after the first 3 loading doses of Avastin.
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